Cats are famously difficult to medicate successfully. Fortunately, compounding medications and customizing them to a cat’s particular tastes is becoming more common. Such meds allow veterinarians to better treat their feline patients and pet parents to successfully administer the treatment.
Cats are particularly sensitive to bitter tastes, and many cat parents often recount their devious tactics to avoid swallowing a bitter pill. Their squirmy maneuvers may make for funny memes on social media, but it’s no joke when it comes to treating an ill cat, especially in situations that require permanent or long-term medication.
What Is Compounding?
The American Veterinary Medical Association website describes compounding as “any manipulation of a drug beyond that described on the drug label based on a licensed veterinarian’s prescription to meet the medical needs of a specific patient.”
Manipulation might include mixing, diluting, concentrating, flavoring, or changing a drug’s dosage form in the following ways:
- Mixing two injectable drugs in the same syringe
- Creating an oral suspension from crushed tablets or an injectable solution
- Adding flavoring to a commercially available medication
- Creating a skin-penetrating gel for a drug typically administered through other routes
- Mixing two solutions for instilling into the ear
Compounding is usually necessary when there is no FDA-approved human or veterinary product to treat the patient. The AVMA notes that the decision to use a compounded preparation must be medically necessary and made within the confines of a veterinarian-client-patient relationship (VCPR).
Jon Nauss, DVM, medical director at Irvine Valley Veterinary Hospital Primary Care & Integrative Medicine, who has trained in veterinary botanical medicine, says it’s important for a veterinarian to discuss all kinds of options for a feline patient.
“This includes everything from diagnostics, treatments, and, of course, home care. When it comes to medications, I try to present as many options as I can. This is driven by discussing the patient in order to get a good understanding as to whether traditional pills, chewable tablets, a liquid, an injectable, or a topical is the most acceptable option,” he says.
“Lately, I’ve found that while many pet parents are much more aware of options for their cats compared to years past, there are still many pet parents, especially if they’ve never had a cat before, that don’t know there are medication options. Typically, most people want take home meds in liquid form for their cats.”
Nicholas Tymochko, PharmD, veterinary pharmacist liaison for Personalized Care Pharmacies—an umbrella company that includes Roadrunner Pharmacies, Atlas Pharmaceuticals, and Covetrus Pharmacies—which collectively offer pet-friendly compounded medicine for pets in all 50 states, agrees, saying, “While the interest in compounded medications has been growing steadily over the last few years, compounds are still very much underutilized. So often, pet owners, and cat owners in particular, struggle with administering their pet’s medication but fail to admit this ‘failure’ to their veterinarian. That’s why those conversations between pet parents and the veterinarian are so important.”
And when it comes to compounding a medication for an individual cat, it’s important to note that what works for one cat may not work for another, Tymochko adds. A veterinary pharmacist can help by consulting with veterinarians about which dose form or flavor may be the best fit for each patient.*
Common Compounded Medications and Customized Options
Dr. Nauss says the most common customized or compounded medications he prescribes are those for chronic conditions such as hyperthyroidism.
“In cats, these are often things like thyroid medication in a gel that is applied to the ears or liquid medications for asthma. Owners should always wear gloves when applying topical medications,” he cautions. “Further, there are some medications that, for reasons of absorption or safety, cannot be given topically.”
Among the medications that can be compounded for cats are gabapentin, prednisone, and mirtazapine. Your veterinarian can tell you if the medication your cat needs can be compounded into a tasty form that’s easier to give.
Apart from liquids and transdermal gels, a variety of pill options are available, including chewables such as Soft Chews and easy-dissolving Mini Melts. They can also be prescribed for other animals such as dogs and horses.
Pet Insurance and Pet Meds
Not all pet health insurance policies cover medications, so check the specifics of your policy.
“We cover compounded medications for eligible conditions as long as that medication is a proven and accepted therapy,” says staff veterinarian Caroline Wilde at Trupanion.
Finding a Compounding Pharmacy
Not all compounding pharmacies specialize in pets, so ask. If you order online, check for a refrigerated delivery option. Many medications must be kept cold, including before arrival at the home, and ultimately refrigerated for home use. Don’t hesitate to shop around, as prices may vary.
“If the prescription is for a temperature-sensitive or temperature-controlled product, it will automatically be shipped with appropriate packaging to preserve the integrity of the medication,” Tymochko says.
Why Liquid Treats and Compounded Medications Go Together
While a liquid suspension drawn into a syringe is easier to give a cat than a pill, even administering a liquid suspension correctly can be a challenge for a pet parent and thus an ordeal for the cat. The liquid medication needs to be squirted into a cat’s cheek pouch so as not to cause them to aspirate.
My Ziggy takes a lot of medication for various issues and, as compliant as he is, I still find it stressful to correctly administer a syringe of medication to him. This is where a liquid treat can really do double duty as a yummy snack and as a “disguised” means to deliver the medication. I have Ziggy’s medications compounded in a tuna flavor and then add them to a tuna-flavored liquid treat. I also mix in his probiotic by opening the capsule and sprinkling the contents into the treat and crush his chewable vitamin B12 (which he won’t chew) and add it too.
He laps it all up and is none the wiser!
This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.
Sandy Robins is an award-winning pet lifestyle journalist and author of For the Love of Cats, Fabulous Felines: Health and Beauty Secrets for the Pampered Cat, The Original Cat Bible, and Making the Most of All Nine Lives: The Extraordinary Life of Buffy The Cat.
Want to stay in the loop on the latest and greatest in keeping your pet happy and healthy? Sign up for our free newsletter by clicking here!
*Covetrus encourages the use of an FDA approved product whenever possible, within a valid veterinary-client-patient relationship (VCPR). However, we realize that in order to achieve a desired therapeutic outcome, a customized compounded preparation may be necessary. Covetrus compounding pharmacies, a fully PCAB accredited pharmacy with compliance to USP 795/797/800 standards along with a registered cGMP 503B outsourcing facility means you can be confident in the quality of every medication order.
Published February 20, 2023